SBRT vs. Robot-assisted radical prostatectomy

Posted by dandl48 Dave @dandl48, Jun 11, 2020

Well, my last visit to Mayo didn't go as well as I wanted. I'm 72 years old and I had an Ultrasound-guided transperineal prostate biopsy and the results came back positive for cancer with a Gleason score of 4-3=7 and the Grade Group of 3 which is a Risk Group of Intermediate Unfavorable. With these results active surveillance is out and it's either radiation or radical prostatectomy . If I choose radiation SBRT is available to me using protons for 5 treatments over a 10 day period. The downside of this treatment is I will have to have a 4 month Lupron injection before radiation and that if the cancer returns removal of the prostate would probably off the table. Choosing the radical prostatectomy which would be robot assisted, comes with its own problems, infection, incontinence and impotence. Decisions, decisions, I'm open for your input.

Thanks, Dave

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

dmadi61 | @dmadi61 | Jun 11, 2020

I was similar to you as well. Stage 3, 4+3=7 Gleason. Since it had spread (stage 3) it was deemed inoperable because I would still need radiation. I was told radiation on an area after an operation could be harmful. I went on Lupron then had High dose brachytherapy and 25 external beam. I was on Lupron for 24 months. If you stay active and communicate with your doctors - 4 months would not be too bad.

horace1818 | @horace1818 | Jun 11, 2020

Dave see my prior posts on this decision. I had exactly the same numbers as you and after agonizing review, chose DaVinci prostatectomy. I do not regret it. Any time you can cure cancer with surgery, you should do it. If you have been reading the recent posts on this site about the side effects of Lupron, radiation etc, you will know the situation. There are downsides from surgery but they are manageable. ED is certain but can be boosted with drugs; there is some leakage on coughing and I have some low level pain in the urethra (rare). But I am now 4 years post surgery with a PSA of zero and retain a healthy libido and function. One thing you should do is to have the Prolaris test done to determine the degree of aggressiveness of your cancer. Best of luck.